IDSA Statement on PAHPA Reauthorization

01/17/2018

The January 17 Senate Health, Education, Labor and Pensions Committee hearing in preparation for reauthorization of the Pandemic and All Hazards Preparedness Act provides a valuable opportunity to consider how best to ensure that states, communities and healthcare facilities have the resources they need to protect against emerging public health threats.

IDSA urges legislators to make the most of that opportunity with a reauthorization that includes strong incentives for the research and development of new antimicrobial drugs, investment in the infectious diseases workforce to lead public health emergency responses, establishment of a rapid
response fund for public health emergencies, and support to strengthen capacities to prevent, detect, and respond to emerging infections globally. In an increasingly interconnected world, an emerging public health threat anywhere poses a potential threat everywhere.

While antimicrobial resistance increasingly poses a serious hazard to our public health and security, our existing antimicrobial arsenal is insufficient to confront the rising tide of antimicrobial-resistant pathogens infecting patients. While a danger on its own, antibiotic resistance can also severely complicate responses to other emergencies, such as an influenza pandemic or terrorist attacks resulting in serious injuries or illnesses.

Current efforts by the Biomedical Advanced Research and Development Authority have been essential to help fund work towards fostering new antibiotics. Still, antibiotic research and development continue to lag well behind existing pressing needs. Companies have little opportunity for return on investment since new antibiotics are only recommended for targeted use that makes high-volume sales of a new product unlikely. IDSA proposes that BARDA be given new funding authority to provide market entry rewards of at least $500 million per new antimicrobial, paid over a period of five years. Such rewards should be reserved for antimicrobials that only address the most urgent unmet needs to treat resistant infections, and require commitments to antimicrobial stewardship and access agreements.

IDSA also urges legislators to prioritize the development of an expert workforce, ready
to mount successful responses to public health emergencies including outbreaks and bioterror attacks.
Unfortunately, ID training leads to careers on the lower end of the physician payscale causing fewer people to pursue this specialty., PAHPA reauthorization should provide new loan repayment opportunities to lessen the economic disincentives that prevent medical students and trainees from selecting infectious diseases careers. Specifically, loan repayment should be offered to individuals who serve in the CDC Epidemic Intelligence Service—the program that provides expert responders to public health emergencies and trains many future public health leaders.

IDSA also supports the establishment of a rapid response fund for public health emergencies such as outbreaks to provide immediate essential responses and serve as a bridge supporting initial efforts to contain the spread of infection; treat infected individuals; and launch research for necessary
vaccines, diagnostics, and therapeutics, as Congress considers additional funding needs. Such a fund must not come at the expense of currently supported public health priorities.

Finally, the recent Ebola and Zika outbreaks underscore the need for the Global Health Security Agenda, a multinational effort with strong U.S. leadership focused on preventing and mitigating outbreaks, improving rapid detection and reporting of outbreaks, and developing an interconnected global network that can efficiently respond to outbreaks to contain their impact.

Halting outbreaks where they begin is one of the most effective ways to protect Americans. We
urge legislators to remember that as they reauthorize PAHPA.